Rebecca Helen Headley

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00542700 Issued in NJ

Practice address

1003 Mallard Way
Pittsgrove, NJ 08318-9159

Phone

(856) 689-7151

NPI assigned

Apr 27, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, VA, PA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mind Your Mind

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hamilton, NJ
  • NPI 1053955096
  Medicare reassignment NPD
• NLP Behavioral Services LLC

  • Psychiatry Physician
  • Freehold, NJ
  • NPI 1104969096
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  PA

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  PA

  Medicare reassignment NPD
• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  NJ

  Medicare reassignment NPD
• Lifebulb LLC

  • Mental Health Counselor
  • Toms River, NJ
  • NPI 1699491464
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1720465958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 MALLARD WAY",
            "city": "PITTSGROVE",
            "state": "NJ",
            "postal_code": "083189159",
            "telephone_number": "856-689-7151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 MALLARD WAY",
            "city": "PITTSGROVE",
            "state": "NJ",
            "postal_code": "083189159",
            "telephone_number": "856-689-7151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6076 Franconia Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223101768",
            "country_code": "US",
            "telephone_number": "703-454-8246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEADLEY",
        "first_name": "REBECCA",
        "middle_name": "HELEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024186029",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00542700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edwin Gomez
• Jacqleen Gonzalez
• Bryne Edward Green Sr.
• Mike M Haddix
• Alexis Chivon Hayes
• Kaitlin Henry
• Jeffrey B Hepler, PT
• David Craig Heyel
• Patricia A Hildebrand, PTA
• Kelly Aileen Howard

• Adult Health Nurse Practitioner in Pittsgrove, NJ
• Providers in Pittsgrove, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.